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目的探讨老年人结直肠癌的外科治疗。方法对复旦大学附属肿瘤医院1985年1月至2003年12月间手术治疗的266例年龄≥75岁的老年人结直肠癌病例资料,进行临床和病理资料的回顾性分析。结果266例中,男性151例,女性115例,年龄75~91岁。病变部位以直肠和乙状结肠多见,占69.2%,但右半结肠癌仍占22.2%。94例(35.3%)术前存在心血管疾病、糖尿病等合并症。215例(80.8%)行根治性手术,35例(13.2%)行姑息性手术治疗。术后30例(11.3%)出现肠梗阻、出血、感染等并发症,其中3例(占1.1%)手术后死亡。全组随访1个月至16年,5年存活率51.3%。结论虽然老年人结直肠癌中术前合并症和术后并发症的发生率较高,但在重视围手术期的检测和处理后手术死亡率并未增加,术后5年存活率仍可达50%以上。因此,对老年人结直肠癌积极的临床诊治不容忽视。

Surgical treatment for colorectal cancer in the elderly patients over 75 years old:an analysis of 266 cases

??Objective:To analyze the clinical and pathological characteristics,surgical complications and prognosis of colorectal cancer (CRC) in the elderly patients,and discuss the surgical treatment for them. Methods:The clinical and pathological data of 266 CRC patients over 75 years old accepted surgical treatment between January 1985 and December 2003 in Cancer Hospital of Fudan University were analyzed retrospectively. Results:Among 266 patients,the age of 151 males and 115 females ranged from 75 to 91 years old.The rectum and sigmoid colon were the most popular sites in the elderly patients (69.2%),but still there were 22.2% of patients with tumors located in the right site of colon.Ninety??four patients (35.3%) had complicated diseases before operation,such as cardiovascular disease and diabetes mellitus.Two hundreds and fifteen patients (80.8%) accepted radical excision while 35 patients (13.2%) accepted palliative resection.Thirty patients (11.3%) had postoperative complications,such as intestinal obstruction,haemorrhage,infection and so on. Among them,3 patients (1.1%) died several days after operation.The overall 5??year survival rate was 51.3%. Conclusion:Though the elderly CRC patients have more complicated diseases before operation and more postoperative complications,the operative mortality is still lower if much more attentions are paid during operation.Also they have the 5??year survival rate more than 50%.So the surgical treatment shouldn’t be ignored in the elderly CRC patients.